Central nervous system paracoccidioidomycosis: analysis os 13 cases

Central nervous system paracoccidioidomycosis: analysis os 13 cases

Title: Central nervous system paracoccidioidomycosis: analysis os 13 cases;
Paracoccidioidomicose do sistema nervoso central: análise de 13 casos
Author Fagundes-Pereyra, Walter J. Autor UNIFESP Google Scholar
Carvalho, Gervasio Teles Cardoso Google Scholar
Góes, Alfredo de Miranda Google Scholar
Silva, Francisco das Chagas Lima e Google Scholar
Sousa, Atos Alves de Google Scholar
Institution Clin Neurol & Neurocirurgia Santa Casa Belo Horiz
Mestre Med Santa Casa Belo Horizonte
Universidade Federal de São Paulo (UNIFESP)
Serv Neurocirurg Santa Casa
Universidade Federal de Minas Gerais (UFMG)
Programa Pos Grad Santa Casa
Abstract Paracoccidioidomycosis (PCM) is a systemic granulomatous disease caused by Paracoccidioides brasiliensis, prevalent in Latin America, particularly in Brazil. Central nervous system (CNS) involvement occur in about 10% of cases. Thirteen patients with PCM involving CNS were studied considering clinical manifestation, neuroradiology and treatment modalities. Age ranged from 30 to 71 years-old (M=47.1 +/- 11.6 Me=46). There were eleven men and two women. the most frequent symptoms were motor deficits (53.8%), cognitive disturbance (53.8%), weight loss (46.1%), headaches (46.1%) and seizures (46.1%). the diagnosis was confirmed by the demonstration of P. brasiliensis. Granulomatous forms were present in all patients. Four (30.8%) of them had also meningeal involvement (mixed form). Computerized tomography (CT) scans were obtained in all cases and magnetic resonance imaging (MRI) was used in one case. Serology for HIV was done in ten patients (76.9%), and all the tests were negatives. Amphotericin B was used in twelve patients (92.3%), one of them by intraventricular infusion. in eight patients (61.5%), trimethopim and sulfamethoxazole were used, and, in two (15.4%), sulfadiazine and pirimetamine. Fluconazole, ketoconazole and itraconazole were each one used in a different patient as well. Six patients died (46.1%) and seven (53.9%) had satisfatory outcome. the follow-up period ranged from 2 to 74 (M=30.9) months. in conclusion, the CNS involvement in paracoccidioidomycosis is more frequent and more serious than thought before. the clinical manifestations, CT scans and MRI findings are not specific of paracoccidioidomycosis.
Keywords paracoccidioidomycosis
central nervous system
Paracoccidioides brasiliensis
Language English
Date 2006-06-01
Published in Arquivos de Neuro-psiquiatria. São Paulo, SP: Assoc Arquivos de Neuro- Psiquiatria, v. 64, n. 2A, p. 269-276, 2006.
ISSN 0004-282X (Sherpa/Romeo, impact factor)
Publisher Assoc Arquivos de Neuro- Psiquiatria
Extent 269-276
Origin http://dx.doi.org/10.1590/S0004-282X2006000200018
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000238113200018
SciELO ID S0004-282X2006000200018 (statistics in SciELO)
URI http://repositorio.unifesp.br/handle/11600/28933

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